Tuesday November 8th, we in the United States will elect a new president. It’s been a contentious , bitter campaign and we are all glad it’s almost over. But we should also be glad that we have the privilege of open discussion and disagreement and settling our differences by voting for our leaders.
I hope you will review my previous post about the presidential candidates’ views and proposals concerning health care. Here I am repeating a previous post that outlines the U.S. healthcare system.
I believe we have one of the best healthcare systems in the world because of the people who work in healthcare- the people who devote years to education and training and who work tirelessly 365 days a year, 24 hours a day to make and keep us well. Their commitment, compassion, dedication and competence benefits all of us and deserves our gratitude.
Even though the United States does not officially have “socialized” health care, a large proportion of our medical care is funded by the federal government. Even though I know that, I was still surprised by statistics in a recent article, which stated that the federal government accounts for
40% of healthcare spending
$1.3 trillion /year
Covering 100 million individuals
Through 4 federal agencies
Department of Health and Human Services
Department of Defense
Department of Homeland Security
(JAMA (Journal of the American Medical Association), June 21, 2016)
The United States Congress passed the Patient Protection and Affordable Care Act (ACA) in 2010 to guarantee basic health insurance to all citizens. People who oppose the ACA ,aka Obama Care, dislike or even fear government involvement in medical care; they consider it interference, control, or even nationalization of the United States healthcare system.
I think many people, even physicians, don’t realize or forget, how involved the government already is in healthcare. As far back as the American Revolution the fledgling government extended health care benefits to the soldiers and veterans of that war; that system evolved into the current military health care system which covers service members and the Veterans’ Administration system for veterans.
Medicaid provides insurance coverage for adults and children who are unemployed or low income.
Medicare covers disabled children and adults and persons 65 years and older.
The numbers are rather staggering.
- Together these programs cover at least 30% of Americans.
- Together they comprise 25% of all federal spending.
- Together they pay 40% of total U.S. health care spending.
An infographic from the Kaiser Family Foundation and JAMA explains this further.
You may not be eligible for either of these programs now, but chances are eventually you or someone close to you will.
- Anyone can become disabled from a serious illness or freak accident.
- You or your spouse may lose your job and your employer sponsored health insurance.
- Your child may have a disability that will prevent them from working when they grow up.
- We may all live long enough to qualify for Medicare on the basis of age alone. Your parents or grandparents are near or already at Medicare age.
It’s important to understand how Medicare works, since it’s not automatic; even if you qualify, you need to sign up to be covered (with a few exceptions). The rules are summarized here. Or consider an easy to understand book here.
Several government agencies regulate, monitor, promote and/or support both public and private healthcare including-
Food and Drug Administration- FDA
Centers for Disease Control and Prevention- CDC
National Institutes of Health- NIH
Occupational Safety and Health administration-OSHA
Drug Enforcement Agency-DEA
Congress has enacted several important laws that concern health care such as
The Affordable Care Act- ACA
Health Insurance Portability and Accountability Act-HIPPA
Emergency Medical Treatment and Labor Act- EMTALA
Health Information Technology for Economic and Clinical Health- HITECH
Americans with Disabilities Act-ADA
Family Medical Leave Act-FMLA
In the Declaration of Independence, the founders of the United States created a nation based on the “self-evident truths” of “Life ,Liberty, and the pursuit of Happiness” as well as to promote “Safety and Happiness” .
In the Constitution they vowed to “promote the general Welfare” .
I wonder if they envisioned that would eventually include so much effort and money providing and regulating health care, most of which was not available or even imagined at that time?
Comments welcome and encouraged!
Before you vote, you may want to review this related post.